European Heart Journal Advance Access originally published online on January 5, 2007
European Heart Journal 2007 28(11):1366-1373; doi:10.1093/eurheartj/ehl456
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Myocardial positive pre-ejection velocity accurately detects presence of viable myocardium, predicts recovery of left ventricular function and bears a prognostic value after surgical revascularization
5
1 From the Cardiocenter, Department of Cardiology, 3rd Medical School Charles University and University Hospital Kralovske Vinohrady Srobarova 50, 100 34 Prague, Czech Republic
2 Cardiovascular Center, OLV Hospital, Aalst, Belgium
3 Department of Nuclear Medicine (O.L.), 3rd Medical School Charles University and University Hospital Kralovske Vinohrady Prague, Czech Republic
4 Department of Radiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
5 Department of Biostatistics and Informatics, National Institute of Public Health, Prague, Czech Republic
Received 2 April 2006; revised 9 November 2006; accepted 7 December 2006; online publish-ahead-of-print 5 January 2007.
* Corresponding author. Tel: +32 53 72 4447; fax: +32 53 72 4550. E-mail address: jozef.bartunek{at}olvz-aalst.be
Aims: To assess the accuracy of tissue Doppler imaging-derived myocardial positive pre-ejection velocity (+Vic) in detecting myocardial viability defined by dobutamine stress echocardiography (DSE), fluorine-18 fluorodeoxyglucose positron emission tomography (PET), and contrast-enhanced magnetic resonance imaging (MRI), and in predicting recovery of left ventricular (LV) function after coronary artery bypass grafting (CABG) in patients with chronic ischaemic LV dysfunction.
Methods and results: +Vic in dysfunctional segments was recorded in 54 patients treated medically and 65 patients undergoing CABG [age 67 ± 9 year; LV ejection fraction (EF) 30 ± 6%]. A good agreement was observed between +Vic and detection of viable myocardium at DSE, PET, and MRI (kappa = 0.76). The presence of +Vic in greater than or equal to five dysfunctional segments had the highest sensitivity (93%) and specificity (60%) to identify patients (n = 28) with 
10% increase in LV EF between baseline and 6-month echocardiogram. During follow-up (median 333 days, interquartile range 209–490 days), 13 cardiac events (6 deaths, 7 hospitalizations) occurred in 24 patients with small extent of viable myocardium (< 5 + Vic), whereas only four hospitalizations in 39 patients with 5 + Vic (54% vs. 10%; P < 0.001).
Conclusion: The extent of +Vic in dysfunctional segments accurately predicts extent of viable myocardium and bears a clinical prognostic value in patients with ischaemic LV dysfunction considered for CABG.
Key Words: Tissue Doppler imaging • Viability • Coronary disease • Echocardiography • Bypass
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Penicka, H. Linkova, O. Lang, R. Fojt, V. Kocka, M. Vanderheyden, and J. Bartunek Predictors of Improvement of Unrepaired Moderate Ischemic Mitral Regurgitation in Patients Undergoing Elective Isolated Coronary Artery Bypass Graft Surgery Circulation, October 13, 2009; 120(15): 1474 - 1481. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Maruskova, P. Gregor, J. Bartunek, J. Tintera, and M. Penicka Myocardial viability and cardiac dyssynchrony as strong predictors of perioperative mortality in high-risk patients with ischemic cardiomyopathy having coronary artery bypass surgery J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 62 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Rahimtoola, V. Dilsizian, C. M. Kramer, T. H. Marwick, and J.-L. J. Vanoverschelde Chronic ischemic left ventricular dysfunction from pathophysiology to imaging and its integration into clinical practice. J. Am. Coll. Cardiol. Img., July 1, 2008; 1(4): 536 - 555. [Abstract] [Full Text] [PDF]
|
|